Lymph system function during cirrhosis

Cirrhosis of the liver is a condition in which liver tissue is replaced by non-functional tissue such as scar tissue and fibrosis. This prevents the liver from functioning normally. A common result of cirrhosis is ascites, a condition in which fluid accumulates in the abdominal cavity, outside of organs. Cirrhosis is commonly caused by alcoholism and hepatitis.

The thoracic duct is the largest lymphatic vessel in the body. Most of the body’s lymphatic vessels lead to the thoracic duct, and so most of the lymph from the body eventually ends up in the thoracic duct. From there, lymph is emptied back into blood circulation.

A study compares the composition and flow rate of lymph between patients with and without cirrhosis. In the first phase of the study, X-ray computed tomography scans are taken of the thoracic duct. The study finds that among patients without cirrhosis, the thoracic duct has an average diameter of $5$‍ mm. However, among patients with cirrhosis, the thoracic duct has an average diameter of $8$‍ mm.

In the second phase of the study, $1$‍ mL of lymph fluid is removed from the thoracic duct using a catheter. It is analyzed for protein content and red blood cells. It is found that among patients with cirrhosis, the red blood cells make up $4\mathrm{\%}$‍ of the lymph, compared to $0\mathrm{\%}$‍ for patients without cirrhosis. Protein content among patients with cirrhosis is found to be approximately $6.4$‍ g/dL for patients with cirrhosis compared to $6.7$‍ g/dL for patients without cirrhosis.